| NPI | 1902160005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA LPC006600) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA 006600) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2020-01-29 |